The proposed research will explore the critiquing approach to computer advice in medicine. The emphasis will be to explore the system design issues involved in building computer systems which critique a physician's own plan for patient care. To explore these design issues, we are implementing several developmental critiquing systems in different areas of medicine. The proposed research will continue this work: VQ-ATTENDING VQ-ATTENDING is currently under development to critique aspects of the ventilator management of a patient receiving mechanical respiratory support. The implementation of this system will continue, and design issues of its "goal-directed" structure will be explored. HT-ATTENDING HT-ATTENDING is designed to critique the pharmacologic management of essential hypertension. HT-ATTENDING will be refined and its knowledge brought up-to-date. Critiquing Differential Diagnosis - A further plan is to extend the critiquing approach into a domain of differential diagnosis. To explore these design issues, we will use the domain of syncope. ESSENTIAL-ATTENDING - A broader goal is to develop a domain-independent "system-building system" to facilitate the implementation of critiquing systems in still other domains. The implementation of VQ-ATTENDING, HT-ATTENDING, and the diagnostic syncope system, using ESSENTIAL-ATTENDING, will allow us to explore domain-independent design issues in a robust fashion.